子宫肌瘤切除术应用右美托咪定在腰硬联合麻醉中的镇静效果观察

Observation of the sedative effect of dexmedetomidine in combined spinal-epidural anesthesia for hysteromyomectomy

目的研究观察子宫肌瘤切除术应用右美托咪定在腰硬联合麻醉中的镇静效果。方法110例行子宫肌瘤切除术腰硬联合麻醉患者,依循随机数字表法将患者分为实验组与对照组,各55例。对照组给予丙泊酚麻醉,实验组给予右美托咪定麻醉。比较两组麻醉前、术中30 min、术后的心率、平均动脉压,镇静效果,不良反应发生率。结果实验组术中30 min的心率(71.8±6.2)次/min、平均动脉压(88.3±6.7)mm Hg(1 mm Hg=0.133 kPa)均高于对照组的(66.0±5.7)次/min、(80.5±6.1)mm Hg,差异有统计学意义(P<0.05)。实验组的镇静有效率98.2%高于对照组的81.8%,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论在子宫肌瘤切除术腰硬联合麻醉应用右美托咪定,可提高手术镇静效果,可避免患者的平均动脉压、心率大幅度变化,且用药安全性有保障,值得应用。

Objective To study and observe the sedative effect of dexmedetomidine in combined spinalepidural anesthesia for hysteromyomectomy.Methods A total of 110 patients undergoing hysteromyomectomy with combined spinal-epidural anesthesia were divided into experimental group and control group according to random numerical table,with 55 cases in each group.The control group received propofol for anesthesia,and the experimental group received dexmedetomidine for anesthesia.The heart rate and mean arterial pressure before anesthesia,30 min during operation and after operation,sedative effect,and occurrence of adverse reactions were compared between the two groups.Results 30 min during operation,the heart rate(71.8±6.2)beats/min and mean arterial pressure(88.3±6.7)mm Hg(1 mm Hg=0.133 kPa)of the experimental group were higher than(66.0±5.7)beats/min and(80.5±6.1)mm Hg of the control group,and the difference was statistically significant(P<0.05).The effective rate of sedation 98.2%of the experimental group was higher than 81.8%of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in incidence of adverse reactions between the two groups(P>0.05).Conclusion Dexmedetomidine in combined spinal-epidural anesthesia for hysteromyomectomy can improve the sedative effect,stable mean arterial pressure and heart rate,and ensure the safety of medication,which is worth applying.